To repeat or to recreate: A contralateral posterior interhemispheric transfalcine transprecuneus approach for recurrent meningiomas at the trigone of the lateral ventricle |
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| Affiliation: | 1. Department of Neurosurgery, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai 200032, China;2. Shanghai Key Lab of Medical Image Computing and Computer Assisted Intervention, Shanghai, China;1. Department of Neurosurgery, University Medical Center Mannheim, Mannheim, Germany;2. Department of Neuropathology, Institute of Pathology, University Hospital Heidelberg and Clinical Cooperation Unit Neuropathology, German Cancer Research Center (DKFZ), Heidelberg, Germany;3. Department of Neurosurgery, Knappschafts-Krankenhaus Bochum-Langendreer, Ruhr-University of Bochum, In der Schornau 23-25, 44892 Bochum, Germany;1. Department of Anatomic Pathology, L25, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA;2. Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland Clinic, Cleveland, OH, USA;1. Department of Neurosurgery, Austin Health, The University of Melbourne, 145 Studley Road Heidelberg, VIC 3070, Australia;2. Department of Anatomical Pathology, Austin Health, The University of Melbourne, VIC, Australia |
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| Abstract: | Surgery in the trigone of the lateral ventricle remains a challenge for neurosurgeons. In recurrent trigonal meningiomas (RTM), the disturbance of normal anatomic structures and adhesion due to previous surgeries, significant oedema, and their malignant properties heighten the difficulties associated with their surgical removal. This report presents two patients with recurrent meningiomas with anaplastic transformation at the trigone of the lateral ventricle who were successfully treated with contralateral posterior interhemispheric transfalcine transprecuneus (CITT) surgeries. The primary tumours were both completely removed through a transparietal approach in previous surgeries, but both patients experienced hemianopsia postoperatively. The second surgeries resulted in the complete resection of the recurrent tumours without any new-onset neurological dysfunction. The CITT approach suits most trigonal lesions with advantages of optic radiation preservation, reduction of retraction, improved exposure, and navigation accuracy, and because it addresses the origin of the trigonal lesion. Although the characteristics of RTM heighten the difficulty associated with their surgical removal, these challenges highlight the advantages of the CITT approach. In conclusion, the CITT approach is a safe and effective procedure for the removal of RTM. |
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| Keywords: | Atrium of lateral ventricle Recurrent meningiomas Surgical approach Trigone of lateral ventricle |
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